|
1
|
Fogante M, Volpato G, Esposto Pirani P, Cela F, Compagnucci P, Valeri Y, Selimi A, Alfieri M, Brugiatelli L, Belleggia S, Coraducci F, Argalia G, Casella M, Dello Russo A, Schicchi N. Cardiac Magnetic Resonance and Cardiac Implantable Electronic Devices: Are They Truly Still "Enemies"? Medicina (Kaunas) 2024; 60:522. [PMID: 38674168 PMCID: PMC11051994 DOI: 10.3390/medicina60040522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Revised: 03/15/2024] [Accepted: 03/20/2024] [Indexed: 04/28/2024]
Abstract
The application of cardiac magnetic resonance (CMR) imaging in clinical practice has grown due to technological advancements and expanded clinical indications, highlighting its superior capabilities when compared to echocardiography for the assessment of myocardial tissue. Similarly, the utilization of implantable cardiac electronic devices (CIEDs) has significantly increased in cardiac arrhythmia management, and the requirements of CMR examinations in patients with CIEDs has become more common. However, this type of exam often presents challenges due to safety concerns and image artifacts. Until a few years ago, the presence of CIED was considered an absolute contraindication to CMR. To address these challenges, various technical improvements in CIED technology, like the reduction of the ferromagnetic components, and in CMR examinations, such as the introduction of new sequences, have been developed. Moreover, a rigorous protocol involving multidisciplinary collaboration is recommended for safe CMR examinations in patients with CIEDs, emphasizing risk assessment, careful monitoring during CMR, and post-scan device evaluation. Alternative methods to CMR, such as computed tomography coronary angiography with tissue characterization techniques like dual-energy and photon-counting, offer alternative potential solutions, although their diagnostic accuracy and availability do limit their use. Despite technological advancements, close collaboration and specialized staff training remain crucial for obtaining safe diagnostic CMR images in patients with CIEDs, thus justifying the presence of specialized centers that are equipped to handle these type of exams.
Collapse
Affiliation(s)
- Marco Fogante
- Maternal-Child, Senological, Cardiological Radiology and Outpatient Ultrasound, Department of Radiological Sciences, University Hospital of Marche, 60126 Ancona, Italy; (P.E.P.); (F.C.); (G.A.)
| | - Giovanni Volpato
- Cardiology and Arrhythmology Clinic, University Hospital “Azienda Ospedaliero-Universitaria delle Marche”, 60126 Ancona, Italy; (G.V.); (P.C.); (Y.V.); (A.S.); (M.A.); (L.B.); (S.B.); (F.C.); (M.C.); (A.D.R.)
| | - Paolo Esposto Pirani
- Maternal-Child, Senological, Cardiological Radiology and Outpatient Ultrasound, Department of Radiological Sciences, University Hospital of Marche, 60126 Ancona, Italy; (P.E.P.); (F.C.); (G.A.)
| | - Fatjon Cela
- Maternal-Child, Senological, Cardiological Radiology and Outpatient Ultrasound, Department of Radiological Sciences, University Hospital of Marche, 60126 Ancona, Italy; (P.E.P.); (F.C.); (G.A.)
| | - Paolo Compagnucci
- Cardiology and Arrhythmology Clinic, University Hospital “Azienda Ospedaliero-Universitaria delle Marche”, 60126 Ancona, Italy; (G.V.); (P.C.); (Y.V.); (A.S.); (M.A.); (L.B.); (S.B.); (F.C.); (M.C.); (A.D.R.)
| | - Yari Valeri
- Cardiology and Arrhythmology Clinic, University Hospital “Azienda Ospedaliero-Universitaria delle Marche”, 60126 Ancona, Italy; (G.V.); (P.C.); (Y.V.); (A.S.); (M.A.); (L.B.); (S.B.); (F.C.); (M.C.); (A.D.R.)
| | - Adelina Selimi
- Cardiology and Arrhythmology Clinic, University Hospital “Azienda Ospedaliero-Universitaria delle Marche”, 60126 Ancona, Italy; (G.V.); (P.C.); (Y.V.); (A.S.); (M.A.); (L.B.); (S.B.); (F.C.); (M.C.); (A.D.R.)
| | - Michele Alfieri
- Cardiology and Arrhythmology Clinic, University Hospital “Azienda Ospedaliero-Universitaria delle Marche”, 60126 Ancona, Italy; (G.V.); (P.C.); (Y.V.); (A.S.); (M.A.); (L.B.); (S.B.); (F.C.); (M.C.); (A.D.R.)
| | - Leonardo Brugiatelli
- Cardiology and Arrhythmology Clinic, University Hospital “Azienda Ospedaliero-Universitaria delle Marche”, 60126 Ancona, Italy; (G.V.); (P.C.); (Y.V.); (A.S.); (M.A.); (L.B.); (S.B.); (F.C.); (M.C.); (A.D.R.)
| | - Sara Belleggia
- Cardiology and Arrhythmology Clinic, University Hospital “Azienda Ospedaliero-Universitaria delle Marche”, 60126 Ancona, Italy; (G.V.); (P.C.); (Y.V.); (A.S.); (M.A.); (L.B.); (S.B.); (F.C.); (M.C.); (A.D.R.)
| | - Francesca Coraducci
- Cardiology and Arrhythmology Clinic, University Hospital “Azienda Ospedaliero-Universitaria delle Marche”, 60126 Ancona, Italy; (G.V.); (P.C.); (Y.V.); (A.S.); (M.A.); (L.B.); (S.B.); (F.C.); (M.C.); (A.D.R.)
| | - Giulio Argalia
- Maternal-Child, Senological, Cardiological Radiology and Outpatient Ultrasound, Department of Radiological Sciences, University Hospital of Marche, 60126 Ancona, Italy; (P.E.P.); (F.C.); (G.A.)
| | - Michela Casella
- Cardiology and Arrhythmology Clinic, University Hospital “Azienda Ospedaliero-Universitaria delle Marche”, 60126 Ancona, Italy; (G.V.); (P.C.); (Y.V.); (A.S.); (M.A.); (L.B.); (S.B.); (F.C.); (M.C.); (A.D.R.)
- Department of Clinical, Special and Dental Sciences, Marche Polytechnic University, 60121 Ancona, Italy
| | - Antonio Dello Russo
- Cardiology and Arrhythmology Clinic, University Hospital “Azienda Ospedaliero-Universitaria delle Marche”, 60126 Ancona, Italy; (G.V.); (P.C.); (Y.V.); (A.S.); (M.A.); (L.B.); (S.B.); (F.C.); (M.C.); (A.D.R.)
- Department of Biomedical Sciences and Public Health, Marche Polytechnic University, 60121 Ancona, Italy
| | - Nicolò Schicchi
- Cardiovascular Radiological Diagnostics, Department of Radiological Sciences, University Hospital of Marche, 60126 Ancona, Italy;
| |
Collapse
|
|
3
|
Lopez-Lopez D, Gestal Vazquez M, Rama-Maceiras P, Gonzalez Pereira A, Casas Reza P. Perioperative management of epicardial pacemakers: A case report. J Clin Anesth 2021; 75:110478. [PMID: 34358851 DOI: 10.1016/j.jclinane.2021.110478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 07/25/2021] [Accepted: 07/27/2021] [Indexed: 10/20/2022]
Affiliation(s)
- David Lopez-Lopez
- Anesthesiology, Perioperative Care and Pain Medicine, Complexo Hospitalario Universitario de A Coruña, A Coruña, Spain.
| | - MarIa Gestal Vazquez
- Anesthesiology, Perioperative Care and Pain Medicine, Complexo Hospitalario Universitario de A Coruña, A Coruña, Spain.
| | - Pablo Rama-Maceiras
- Anesthesiology, Perioperative Care and Pain Medicine, Complexo Hospitalario Universitario de A Coruña, A Coruña, Spain.
| | - Almudena Gonzalez Pereira
- Anesthesiology, Perioperative Care and Pain Medicine, Complexo Hospitalario Universitario de A Coruña, A Coruña, Spain.
| | - Pablo Casas Reza
- Anesthesiology, Perioperative Care and Pain Medicine, Complexo Hospitalario Universitario de A Coruña, A Coruña, Spain.
| |
Collapse
|
|
4
|
Streckenbach SC, Dalia AA. Perioperative Management of Cardiac Implantable Electronic Devices: A Single-Center Report of 469 Interrogations. J Cardiothorac Vasc Anesth 2021; 35:3183-3192. [PMID: 34039525 DOI: 10.1053/j.jvca.2021.04.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 04/15/2021] [Accepted: 04/16/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Anesthesiologists increasingly are involved in the perioperative management of cardiac implantable electronic devices (CIEDs). The variety of devices available and the ongoing advancements in technology, programming capabilities, and responses to conventional management (eg, magnet application) complicate the management of these devices. As an aid to this clinical challenge, this manuscript reviews 469 interrogations performed by a single cardiac anesthesiologist during a 4.5-year period to derive useful information with which to guide anesthesiologists who have chosen to pursue training in this area of perioperative care. DESIGN Retrospective review of prospectively collected data. SETTING Single institution, quaternary care hospital. PARTICIPANTS Patients with CIEDs presenting for surgery; the quality assurance (QA) reports of 469 interrogations performed between May 2015 and September 2019 were reviewed. INTERVENTIONS No intervention. MEASUREMENT AND MAIN RESULTS The distributions of surgical procedures, device types, device manufacturers, pacing modes, rate-response sensors, special functions, and performed interventions were reviewed and analyzed. The QA reports were evaluated to identify information or experiences that demonstrated important lessons for anesthesiologists engaging in perioperative CIED management. CONCLUSIONS This database review provides general guidance for anesthesiologists managing CIEDs in the perioperative period. Concepts germane to the operating room are emphasized.
Collapse
Affiliation(s)
- Scott C Streckenbach
- Division of Cardiac Anesthesiology, Department of Critical Care, Anesthesia, and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Adam A Dalia
- Division of Cardiac Anesthesiology, Department of Critical Care, Anesthesia, and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
| |
Collapse
|
|
5
|
Streckenbach S, Lai Y, Bas H, Crowley J, Salzsieder H, Mela T, Dalia AA. Starting an Anesthesia-Based Perioperative Device Management Service: A Practical Guide to Training Anesthesiologists. J Cardiothorac Vasc Anesth 2020; 35:1006-1017. [PMID: 33341343 DOI: 10.1053/j.jvca.2020.11.044] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 11/09/2020] [Accepted: 11/20/2020] [Indexed: 11/11/2022]
Affiliation(s)
- Scott Streckenbach
- Department of Anesthesiology, Pain Medicine, and Critical Care Medicine, The Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Yvonne Lai
- Department of Anesthesiology, Pain Medicine, and Critical Care Medicine, The Massachusetts General Hospital, Harvard Medical School, Boston, MA; Division of Cardiac Surgical Intensive Care Unit, The Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Heidi Bas
- Department of Anesthesiology, Pain Medicine, and Critical Care Medicine, The Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Jerome Crowley
- Department of Anesthesiology, Pain Medicine, and Critical Care Medicine, The Massachusetts General Hospital, Harvard Medical School, Boston, MA; Division of Cardiac Surgical Intensive Care Unit, The Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Hanz Salzsieder
- Department of Cardiology, Division of Electrophysiology, The Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Theofanie Mela
- Department of Cardiology, Division of Electrophysiology, The Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Adam A Dalia
- Department of Anesthesiology, Pain Medicine, and Critical Care Medicine, The Massachusetts General Hospital, Harvard Medical School, Boston, MA.
| |
Collapse
|